Quality of life impairment in patients with newly diagnosed multiple myeloma who suffered from russian military aggression in ukraine: a single center experience

Abstract

Background: A number of factors influence the quality of life (QoL) of patients with multiple myeloma (MM). First of all, the fact of hemato-oncological diagnosis itself and the prognosis for life and work capacity. From February 24, 2022, all patients in Ukraine have an additional factor of negative impact on their QoL: military hostilities, lack of opportunity to live in their own houses and be treated in hospitals in their Region. This fact requires a detailed study in order to timely identify and prevent severe cases of anxiety and depression. Aims: to assess QoL in patients with newly diagnosed MM, who were internally displaced to more safe central region of Ukraine due to russian military aggression from the territories of active hostilities. Methods: The study involved 42 patients with newly diagnosed MM. All patients were treated in Hematology department of Poltava Regional Clinical Hospital n.a.M.V.Sklifosovsky during 2022 year. The cohort consisted of 24 (57%) males and 18 (43%) females, mean age 64.2±9.6 years, ECOG I-III. The patients were divided into two groups: I (n=31) – MM pts, who were native citizens of Poltava region; II (n=11) – MM pts, internally displaced persons from the regions of active hostilities: 9 were from Kharkiv Region, 1 patient from Sumy region and 1 – Luhansk region. The compared groups did not significantly differ by age, gender, ECOG score and ISS staging. QoL of patients was assessed using EQ-5D-5L questionnaire, which included descriptive data and visual analog score (EQ-VAS) data. The study was approved by the local ethic committee and all patients gave a written consent before they were included. Results: Patients of groups reported violations of mobility, self-care, usual activities and pain/discomfort data, that were not significantly different between groups. The anxiety/depression EQ-5D-5L component in patients of group I showed the presence of this violation in 14 (45.2%) cases: 6 (19.4%) patients had slight problems, 4 (12.9%) pts – moderate and 4 (12.9%) pts –severe. Meanwhile, 9 (81.9%) patients of group II, who have suffered from russian military aggression reported the presence of anxiety/depression: 3 (27.3%) pts had slight problems, 3 (27.3%) pts – moderate, 2 (18.2%) pts – severe and 1 (9.1%) patient had extreme problems. Thus, the need to move to another region due to hostilities definitely leads to increase in anxiety and depression, X2 (1, N=42) = 4.4, p < .05. The mean self-rated health score (EQ-VAS) for pts of group I was 57.42 (SD 3.32), which was significantly higher in comparison with the results of group II responders 45.45 (SD 4.64), which is 1.3-fold lower than the indicators of group I, t(42)= 2.4, p = .01.